23 March 2017
During a routine inspection
At the time of the inspection, the service provided support to 13 people. However, only six of those people required support to meet their personal care needs. Therefore, we only looked at the care and support received by those people.
This inspection took place on 23 and 24 March 2017 and was announced. The service was last inspected on 22 March 2013, when it was compliant with the regulations relevant at that time.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People's rights were upheld because staff displayed a good understanding of the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguarding (DoLS). People were encouraged to make choices and were involved in the care and support they received. However, some people did not have mental capacity to make complex decisions about their health and welfare. Where this was the case, people’s records did not always contain an assessment of their capacity. Where decisions had been made in people’s best interests these were not always being fully documented. This meant we were unable to tell, if decisions were specific, made in consultation with appropriate people such as relatives or were being reviewed. We raised this with the registered manager who agreed that people’s records did not contain sufficient information to demonstrate the service was working within the principals of the MCA. The registered manager assured us they would take immediate action to address this. We did not find that people had been disadvantaged or that decisions taken were not in people's best interest.
People told us they felt safe and comfortable with the staff that supported them. One person said, “I do feel safe, the staff work for me.” Were people were unable to tell us their views we observed the way they interacted with their environment and the staff supporting them. We saw people were relaxed and at ease in their environment and with their support workers. Relatives told us they did not have any concerns about people’s safety. One relative said, “People are safe and well looked after, it’s as good as it gets”.
People were protected from the risks of abuse and harm. Staff had received training in safeguarding adults and knew how to recognise signs of potential abuse. They understood how to report concerns and were confident any issues would be dealt with thoroughly.
Recruitment procedures were robust and records demonstrated the service had carried out checks to help ensure staff employed were suitable for their role. Staff received appropriate training that enabled them to carry out their roles effectively. Newly appointed staff undertook a comprehensive induction, shadowed more experienced staff, and did not work alone until the registered manager was confident they had the right skills to carry out their role. One staff member said, “The support we receive is brilliant, the management team really value what we do.”
People were supported by kind and caring staff who ensured people received support that was responsive to their needs as set out within their individual support plans. People were involved in developing their care and encouraged to contribute to them as much or as little as they wished. People told us staff treated them with respect and were mindful of their need for space and privacy.
People were supported to manage their medicines safely. People received their medicines as prescribed, on time and understood what they were for. People were supported to maintain good health and had regular access to health and social care professionals, such as GPs, dietician, speech and language therapist and care managers.
People were kept safe because risks associated with people’s support needs; lifestyle choices as well as those relating to the environment had been identified and action taken to minimise and reduce the risk of any harm to the individual or others. Where risks had been identified, management plans were developed to help ensure staff knew how to support people safely.
There was a complaints procedure in place and people knew how to voice their concerns if they were unhappy. There was a clear management structure and visible leadership within the service. The service had an effective quality assurance system in place to help identify areas of improvement and enable the provider to address them promptly.
The registered provider had notified the Care Quality Commission of significant events, which had occurred in line with their legal responsibilities. Records were well maintained and stored securely